Outline

Introduction: Peritoneal carcinomatosis until recently were considered incurable. Interdisciplinary multimodal therapy including extensive cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) offers significant survival benefit. So far, no radiomorphological imaging can predict the intraoperative tumor load. Combined FDG-PET-CT-scan might offer an impact on patient selection, because its findings might influence making the decision for peritonectomy and HIPEC. We evaluated the results of preoperative FDG-PET-CT-scan by correlating the findings of metabolic imaging with the intraoperative findings of patients who underwent peritonectomy and HIPEC.

Material and methods: Eleven consecutive patients (mean age: 61,45years) underwent preoperative FDG-PET-scans, followed by cytoreductive surgery and HIPEC. The intraperitoneal tumor load was assessed preoperatively by FDG-PET-CT-scan according to the Peritoneal-Carcinomatosis-Index (PCI-PET-CT) according to the intraoperative PCI reported by Sugarbaker (PCI-Sugarbaker). Both indices (PCI-PET-CT and PCI-Sugarbaker) underwent correlation analysis. Moreover we divided the abdominal quadrants into 4 regions (1: upper abdomen, 2: middle abdomen, 3: lower abdomen-pelvis, 4: intestine including jejunum and ileum) and correlated again the different regions.

Conclusion: The PCI-FDG-PET-CT correlates well with the intraoperative Peritoneal-Carcinomatosis-Index by Sugarbaker. Further studies are warranted investigating the potential impact of FDG-PET-CT on preoperative patient selection for peritonectomy and HIPEC in patients suffering from peritoneal carcinomatosis.